Vertigo and Physical Therapy: How a Physical Therapist Can Help Stop the Room From Spinning

Most people think of going to a physical therapist when recovering from a fracture or after suffering a sports injury. However, seeing a physical therapist is also a good option for those who suffer from the distressing condition called vertigo.

What to expect at your first appointment  

When you attend your first physical therapy appointment for vertigo, your therapist will perform an evaluation and do some maneuvers to determine if your dizziness is likely caused by benign paroxysmal positional vertigo (BPPV).

One of the most common methods is the Dix-Hallpike test. The physical therapist rapidly lowers you into the supine position with your head extended off the treatment table. This is done to see if you experience a return of your vertigo symptoms. You will be observed for signs of nystagmus, which is indicated by rapid eye movements. If this occurs, it will confirm the diagnosis of benign paroxysmal positional vertigo.

If you are unable to tolerate being placed in a supine position, your therapist can perform a similar test while you lie on your side. You will move from a seated position to a side-lying position while keeping your head on the table. The therapist will then manually rotate your head in a 45-degree angle to see if nystagmus occurs.

BPPV is caused when tiny crystals in the ear become dislodged and travel into the semicircular canals. BPPV usually only affects one of the semicircular canals of the ear, but at times can affect both the right and left sides. Your physical therapist will be able to pinpoint which canal is causing your problem based on how you react to the testing.

If these tests do not re-create your vertigo symptoms, your dizziness may be caused by a central nervous system dysfunction, and you will likely be referred to your family physician for further testing.

Understanding treatment methods

Once the physical therapist determines you have BPPV, you will typically be treated using either the Epley, Semont, Half-Somersault, or Brandt-Daroff maneuver. These methods use various head rotations and positional changes to re-position the small particles in the ears that cause the vertigo.

Your therapist will determine which method is best for you based on your exam and which canal of the ear is affected. You will also be given instructions on how to perform these methods at home until your vertigo symptoms fully resolve. You may be asked to sleep in a recliner in an upright position and avoid sudden head movements when recovering from a bout of vertigo.

While vertigo can be distressing and scary, consulting with a physical therapist like those at Advance Physical Therapy & Sports Rehabilitation will help you gain a better understanding of your condition. You will also be instructed in treatments to use at home to ease your symptoms if they reoccur.